锥形束CT研究不同基台角度对上颌前牙区牙槽骨改变的影响

doi:10.3969/j.issn.1674-8115.2021.03.009

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (3): 339-343.doi: 10.3969/j.issn.1674-8115.2021.03.009

锥形束CT研究不同基台角度对上颌前牙区牙槽骨改变的影响

袁剑鸣¹(), 魏斌²(), 许卫星³(), 张磊⁴

^1.上海市黄浦区第二牙病防治所修复科，上海 200020
^2.上海交通大学医学院附属第九人民医院口腔第一门诊部，上海 200011
^3.上海市黄浦区第二牙病防治所特需门诊，上海 200020
^4.上海市黄浦区第二牙病防治所综合治疗科，上海 200020

收稿日期:2020-05-20 出版日期:2021-03-28 发布日期:2021-04-06
通讯作者: 魏斌,许卫星 E-mail:yjm_120@163.com;drweibin2003@126.com;smlstar868@163.com
作者简介:袁剑鸣（1983—），男，副主任医师，硕士；电子信箱：yjm_120@163.com。
基金资助:
上海市黄浦区科委科技项目基金(HKW201632);上海市黄浦区医疗卫生重点研究发展专科项目基金(HWZFK201810)

CBCT effects of different abutment angles on alveolar bone changes in maxillary anterior teeth

Jian-ming YUAN¹(), Bin WEI²(), Wei-xing XU³(), Lei ZHANG⁴

^1.Department of Prosthodontics, the Second Stomatological Disease Institution of Huangpu District in Shanghai, Shanghai 200020, China
^2.First Dental Clinic, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
^3.VIP Clinic, the Second Stomatological Disease Institution of Huangpu District in Shanghai, Shanghai 200020, China
^4.Department of Synthetics, the Second Stomatological Disease Institution of Huangpu District in Shanghai, Shanghai 200020, China

Received:2020-05-20 Online:2021-03-28 Published:2021-04-06
Contact: Bin WEI,Wei-xing XU E-mail:yjm_120@163.com;drweibin2003@126.com;smlstar868@163.com
Supported by:
Science and Technology Project Fund of Shanghai Huangpu District Science and Technology Commission(HKW201632);Foundation for Medical and Health Key Research and Development of Huangpu District in Shanghai(HWZFK201810)

摘要/Abstract

摘要：

目的·比较上颌骨前牙区的种植体在使用不同角度的基台修复后牙槽骨改变情况的影像学差异。方法·选择2017年1月—2018年12月在上海市黄浦区第二牙病防治所接受上颌前牙区种植修复的患者40例，按修复基台角度不同分为2组，每组20例，分别使用0°和25°基台修复。在安装角度基台后的即刻、6个月、12个月、18个月时行锥形束CT（cone beam computed tomography， CBCT）检查，测量2组角度基台在各时期的唇侧牙槽骨厚度和高度的CBCT变化差值，并通过自身对照研究和配对t检验比较组间差异。结果·0°和25°基台组在修复后6个月、12个月和18个月时的CBCT比较显示，2组种植体唇侧牙槽骨厚度和高度的变化差异均无统计学意义。结论·采用CBCT影像检查可以量化分析种植体周围牙槽骨的变化。影像学研究显示上颌前牙区种植修复时选择的基台角度在25°以内时，基台角度对牙槽骨的改变没有显著性影响。

关键词: 锥形束CT, 种植体, 角度基台, 牙槽骨

Abstract:

Objective·To compare the imaging differences of alveolar bone changes after using different angles of abutment implants in the maxillary anterior area.

Methods·Forty patients of maxillary anterior area implant restoration at the Second Stomatological Disease Institution of Huangpu District in Shanghai from January 2017 to December 2018 were divided into 2 groups according to the different angle of abutment, with 20 cases in each group, which were treated with the 0° and 25° abutment, respectively. Cone beam computed tomography (CBCT) examination was performed immediately, 6 months, 12 months and 18 months after angular abutment restoration, and the differences of CBCT changes in the thickness and height of labial alveolar bone between the two groups at different periods was measured by self-control study and paired t test.

Results·CBCT comparison of 0° and 25° groups at 6 months, 12 months and 18 months after restoration showed no significant difference in the thickness and height of alveolar bone in the two groups.

Conclusion·Change of alveolar bone around the implant can be quantified by using CBCT image examination. When the base angle of the maxillary anterior tooth area is within 25°, the base angle has no significant effect on the change of alveolar bone.

Key words: cone beam computed tomography (CBCT), implant, angle abutment, alveolar bone

中图分类号:

R783.6

袁剑鸣, 魏斌, 许卫星, 张磊. 锥形束CT研究不同基台角度对上颌前牙区牙槽骨改变的影响[J]. 上海交通大学学报(医学版), 2021, 41(3): 339-343.

Jian-ming YUAN, Bin WEI, Wei-xing XU, Lei ZHANG. CBCT effects of different abutment angles on alveolar bone changes in maxillary anterior teeth[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(3): 339-343.

图/表 8

图 1 T0时点的CT影像图Note:White contour line is the image contour of alveolar bone immediately after restoration.

Fig 1 CT image at time T0

图2 唇侧牙槽骨厚度变化测量位点及牙槽嵴顶高度变化测量位点

Fig 2 Measurement site of alveolar bone thickness and height change of alveolar crest

图3 T1时点唇侧牙槽骨厚度及高度变化

Fig 3 Changes of alveolar bone thickness and height at T1

表1 T1时点2组患者牙槽骨观测点平均变化值的比较（x±s，mm）

Tab 1 Comparison of the mean changes of alveolar bone observation points between the two groups at T1 （x±s，mm）

Observation point	0°abutment group （N=20）	25°abutment group （N=20）	P value
Change value of labial alveolar bone at 0.5 mm of implant neck	0.27±0.09	0.31±0.11	0.141
Change value of labial alveolar bone at 2 mm of implant neck	0.29±0.08	0.31±0.08	0.159
Changes in alveolar crest height on the labial side of implant	0.24±0.09	0.22±0.07	0.260

图4 T2时点唇侧牙槽骨厚度及高度变化

Fig 4 Changes of alveolar bone thickness and height at T2

表2 T2时点2组患者牙槽骨各观测点平均变化值的比较（x±s，mm）

Tab 2 Comparison of the mean changes of alveolar bone observation points between the two groups at T2 （x±s，mm）

Observation point	0° abutment group （N=20）	25° abutment group （N=20）	P value
Change value of labial alveolar bone at 0.5 mm of implant neck	0.45±0.17	0.43±0.15	0.358
Change value of labial alveolar bone at 2 mm of implant neck	0.43±0.13	0.44±0.14	0.412
Changes in alveolar crest height on the labial side of implant	0.39±0.12	0.38±0.16	0.392

图5 T3时点唇侧牙槽骨厚度及高度变化

Fig 5 Changes of alveolar bone thickness and height at T3

表3 T3时点2组患者牙槽骨各观测点平均变化值的比较（x±s，mm）

Tab 3 Comparison of the mean changes of alveolar bone observation points between the two groups at T3 （x±s，mm）

Observation point	0° abutment group （N=20）	25° abutment group （N=20）	P value
Change value of labial alveolar bone at 0.5 mm of implant neck	0.51±0.21	0.55±0.19	0.269
Change value of labial alveolar bone at 2 mm of implant neck	0.52±0.26	0.56±0.20	0.293
Changes in alveolar crest height on the labial side of implant	0.51±0.14	0.53±0.13	0.366

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锥形束CT研究不同基台角度对上颌前牙区牙槽骨改变的影响

CBCT effects of different abutment angles on alveolar bone changes in maxillary anterior teeth

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